Home > Weekly Newsletters > Pain & Arthritis

FRIDAY, Aug. 4 (HealthDay News) -- Chronic fatigue syndrome has been accepted as a medical condition for almost 20 years. Once passed off as a series of sometimes ambiguous complaints about pain in the joints and a general malaise -- primarily by females -- the condition was confirmed by medical researchers as bona fide in 1988.

But classifying a painful physical condition as real doesn't necessarily mean that there is a specific treatment to make it better. What follows is a good example:

The young girl had been receiving treatment for chronic fatigue syndrome for three years before anyone at the Johns Hopkins Children's Center noticed her special condition.

In evaluating the girl's condition, Dr. Peter Rowe thought he had looked at everything. Then, a lab clinician made an offhand observation that the girl also had joints that could bend and twist much more than normal.

"I was chagrined that my physical examination had not included that. So, we decided to look into it," Rowe, a professor of pediatrics, told HealthDay.

What he and other researchers found was puzzling, to say the least.

Sixty percent of the 60 children and teens they treated for chronic fatigue syndrome also had hypermobility in at least four of their joints. Only 20 percent of the general public has a single hyperflexible joint, such as being able to bend a pinkie 90 degrees backward, touch the thumb to the forearm, or bend at the waist and rest both hands flat on the ground.

"It was a surprise," Rowe said of the discovery. "Some of the kids would be able to put their leg behind their head in a seated position. Others could do the splits. Once we saw this over and over, we thought it was something that needed more study."

Their findings, which appeared in the Journal of Pediatrics, add a vexing wrinkle to the current thinking on chronic fatigue syndrome.

In the past, some doctors regarded the syndrome as a psychosomatic byproduct of depression. And those who saw it as a legitimate illness could find few physiological signs of it.

"In the past, you had a tremendous amount of skepticism about [the syndrome], which created a certain amount of stigma for people who have it," said Leonard Jason, a professor of psychology and director of the Center for Community Research at DePaul University in Chicago.

The recent study, he added, "could ultimately lead to us understanding the physiology of this condition."

The syndrome affects four adults per 1,000, but fewer children. To be diagnosed with it, a person must have a sudden onset of fatigue that lasts at least six months. There must also be four of the following eight symptoms: impaired memory, sore throat, tender neck or tender lymph nodes in the arm pit, muscle pain, joint pain, new headaches, troubled sleep and a feeling of malaise after exertion.

Rowe emphasized that having hyperflexible joints doesn't mean a person will have the syndrome. Just how the two are related is little more than a guess, Rowe and Jason agreed.

Children develop joint mobility in their early years, while the chronic fatigue syndrome doesn't generally show itself until puberty. It is difficult to find a causal relationship between the two, because not everyone who has the syndrome also has joint hypermobility, Rowe said.

Still, he wondered whether flexible joints may stress the peripheral nerves in the arms and legs, thereby fatiguing the entire nervous system, or the excessive range of motion may indirectly cause the syndrome.

"For example, if you're prone to injury because of your joints, you might decrease your activity, which studies have shown can lead to [the syndrome]," Rowe said.

To find better treatments for chronic fatigue syndrome, Rowe said he wanted to study hyperflexible joints in greater depth, and test whether they are also more common in adults with the syndrome.

Jason, though, said research should be aimed at genetics.

"I think there may be some genetic factors. We really should look at the parents. There could very well be a number of things passed on that make kids more prone to [the syndrome]," Jason said.

More information

A fact sheet about chronic fatigue syndrome is available at the U.S. National Institutes of Health.

MONDAY, July 24 (HealthDay News) -- While mutations in a gene called matrilin-3 have been linked with hand osteoarthritis and skeletal deformities in humans, researchers say the unmutated gene prevented the onset of osteoarthritis in adult mice, a new study has found.

Matrilin-3 plays a role in early bone development, controls bone mineral density in adults, and prevents osteoarthritis later in life, according to researchers at Rhode Island Hospital.

Reported in the August issue of the American Journal of Pathology, the study is the first to demonstrate that the absence of matrilin-3 leads to osteoarthritis, a joint disease characterized by deterioration of the cartilage.

Mice that lacked the gene had higher rates of osteoarthritis later in life than other mice, the study found.

"Clearly, there is a correlation between matrilin-3 and osteoarthritis. Potentially, we could use (the gene) as a diagnostic tool or to predict whether someone is likely to develop osteoarthritis," study senior author Qian Chen, director of cell and molecular biology and head of orthopaedic biology research at the hospital, said in a prepared statement.

This research has also led to the development of an animal model that can be used to study arthritis in real time, Chen said.

"In the long term, it helps us understand the mechanism of human osteoarthritis development. Very few molecules have even been associated with osteoarthritis, so this is a huge deal," Chen said.

More information

The Arthritis Foundation has more about osteoarthritis  .

(HealthDay News) -- Bunions are hard, painful bumps that appear on the big toe joint. Bunions appear most often in women, and are usually caused by wearing fashionable tight, pointy and narrow high-heeled shoes that constrict the foot.

Once a bunion has formed, according to the American Academy of Orthopaedic Surgeons, the joint may continue to swell and become more and more red and painful. Walking may become difficult, and the bunion may even cause arthritis and misalignment of other toes.

The most effective way to prevent bunions is by wearing comfortable, correctly fitting shoes. They should be wide in the instep and in the toes, and have cushioned soles and a heel no higher than 2 1/4 inches. If you already have a bunion, you can wear cushioned pads inside the shoe to protect the joint from further damage.

In some cases, the bunion may be so severe that surgery is necessary.